School Resource Officer - Confidential Reporting Form
Any student or parent can inform the School Resource Officer about any situation or problem that you know about. These situations may be in school or outside of the school building. Please provide as much detail about the situation as possible.
The information you provide will be held in the strictest confidence. There are instances, however that are required by law to be reported to additional proper authorities including acts that may harm self or others.
False reporting of an incident is against the law and school policy.
Date of the Incident (if known)
Timing of incident?
I was a
A Witness or Bystander
Type of Incident?
Bullying or Negative Peer Interaction
Person/people involved in the incident
Please give some details about the incident.
Did you tell an adult about the incident?
If you answered "Yes" above, who did you tell?
Your Name (to contact for more information)
Phone Number (if you are not a current student)
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This form was created inside of Adams Central Community Schools.